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Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients

BACKGROUND: Lung cancer is a frequent comorbidity of chronic obstructive pulmonary disease (COPD). However, the local risk of developing lung cancer related to regional emphysema distribution and clinical outcome has not been investigated. Our aim was to evaluate the impact of regional emphysema sco...

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Autores principales: Heo, Jung Won, Kang, Hye Seon, Park, Chan Kwon, Kim, Sung Kyoung, Kim, Ju Sang, Kim, Jin Woo, Kim, Seung Joon, Lee, Sang Haak, Yeo, Chang Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488536/
https://www.ncbi.nlm.nih.gov/pubmed/32917179
http://dx.doi.org/10.1186/s12890-020-01268-7
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author Heo, Jung Won
Kang, Hye Seon
Park, Chan Kwon
Kim, Sung Kyoung
Kim, Ju Sang
Kim, Jin Woo
Kim, Seung Joon
Lee, Sang Haak
Yeo, Chang Dong
author_facet Heo, Jung Won
Kang, Hye Seon
Park, Chan Kwon
Kim, Sung Kyoung
Kim, Ju Sang
Kim, Jin Woo
Kim, Seung Joon
Lee, Sang Haak
Yeo, Chang Dong
author_sort Heo, Jung Won
collection PubMed
description BACKGROUND: Lung cancer is a frequent comorbidity of chronic obstructive pulmonary disease (COPD). However, the local risk of developing lung cancer related to regional emphysema distribution and clinical outcome has not been investigated. Our aim was to evaluate the impact of regional emphysema score (RES) on tumor location and prognosis in non-small cell lung cancer (NSCLC) patients. METHODS: We enrolled 457 patients who underwent curative surgery for NSCLC at seven hospitals at The Catholic University of Korea from 2014 to 2018. Emphysema was visually assessed for each lobe, with the lingula as a separate lobe. Semi-quantitative emphysema scoring was classified as follows: 0 = none, 0.5 = 1 to 10%, 1 = 11 to 25%, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. An RES was given to each of the six lung zone: the upper, middle, and lower lobes in the right and left lungs. RESULTS: There were 145 patients in the high RES (≥ 3) group and 312 in the low RES (< 3) group. The mean RES in each lobe with cancer was significantly higher than that in other lobes without cancer (0.51 vs. 0.37, P <  0.001). This group showed significantly shorter disease-free survival (P <  0.001), in addition, presence of COPD, low diffusing capacity of the lung for carbon monoxide (< 80), smoking status, and poor differentiation were more frequent in this group. Also, cancer in a lobe with a higher RES (odds ratio (OR) = 1.56; 95% confidence interval (CI:1.01–2.42; P = 0.04), pathologic stage ≥ III (OR = 2.23; 95% CI: 1.28–3.89; P <  0.001), and poor differentiation (OR = 1.99; 95% CI: 1.22–3.21; P <  0.001) were independent factors for tumor recurrence. CONCLUSIONS: The regional severity of emphysema by visual qualification was associated with the location of lung cancer, and was an independently poor prognostic factor for tumor recurrence in completely resected NSCLC patients.
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spelling pubmed-74885362020-09-16 Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients Heo, Jung Won Kang, Hye Seon Park, Chan Kwon Kim, Sung Kyoung Kim, Ju Sang Kim, Jin Woo Kim, Seung Joon Lee, Sang Haak Yeo, Chang Dong BMC Pulm Med Research Article BACKGROUND: Lung cancer is a frequent comorbidity of chronic obstructive pulmonary disease (COPD). However, the local risk of developing lung cancer related to regional emphysema distribution and clinical outcome has not been investigated. Our aim was to evaluate the impact of regional emphysema score (RES) on tumor location and prognosis in non-small cell lung cancer (NSCLC) patients. METHODS: We enrolled 457 patients who underwent curative surgery for NSCLC at seven hospitals at The Catholic University of Korea from 2014 to 2018. Emphysema was visually assessed for each lobe, with the lingula as a separate lobe. Semi-quantitative emphysema scoring was classified as follows: 0 = none, 0.5 = 1 to 10%, 1 = 11 to 25%, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. An RES was given to each of the six lung zone: the upper, middle, and lower lobes in the right and left lungs. RESULTS: There were 145 patients in the high RES (≥ 3) group and 312 in the low RES (< 3) group. The mean RES in each lobe with cancer was significantly higher than that in other lobes without cancer (0.51 vs. 0.37, P <  0.001). This group showed significantly shorter disease-free survival (P <  0.001), in addition, presence of COPD, low diffusing capacity of the lung for carbon monoxide (< 80), smoking status, and poor differentiation were more frequent in this group. Also, cancer in a lobe with a higher RES (odds ratio (OR) = 1.56; 95% confidence interval (CI:1.01–2.42; P = 0.04), pathologic stage ≥ III (OR = 2.23; 95% CI: 1.28–3.89; P <  0.001), and poor differentiation (OR = 1.99; 95% CI: 1.22–3.21; P <  0.001) were independent factors for tumor recurrence. CONCLUSIONS: The regional severity of emphysema by visual qualification was associated with the location of lung cancer, and was an independently poor prognostic factor for tumor recurrence in completely resected NSCLC patients. BioMed Central 2020-09-11 /pmc/articles/PMC7488536/ /pubmed/32917179 http://dx.doi.org/10.1186/s12890-020-01268-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Heo, Jung Won
Kang, Hye Seon
Park, Chan Kwon
Kim, Sung Kyoung
Kim, Ju Sang
Kim, Jin Woo
Kim, Seung Joon
Lee, Sang Haak
Yeo, Chang Dong
Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients
title Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients
title_full Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients
title_fullStr Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients
title_full_unstemmed Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients
title_short Regional emphysema score is associated with tumor location and poor prognosis in completely resected NSCLC patients
title_sort regional emphysema score is associated with tumor location and poor prognosis in completely resected nsclc patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488536/
https://www.ncbi.nlm.nih.gov/pubmed/32917179
http://dx.doi.org/10.1186/s12890-020-01268-7
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